Nothing in life had prepared me for the wondrous joys of motherhood. The sweet little baby sounds, adorable little hands and feet, and the constant need to hold, cuddle or caress this new little bundle of love.

All was bliss until three months after the birth of Tristan, our first child. Little did I know that our journey was about to take a turn up a long and at times incredibly steep hill – no, make that a treacherous mountain.

At three months of age, Tristan was diagnosed with eczema. Although he never had that super soft baby skin I was expecting at birth, his dry skin had started to develop small, raised, red patches. We consulted our pediatrician who prescribed topical corticosteroids. At the time, I had no idea there were other options, especially for a mild case, so we applied his medication as instructed.

Things gradually worsened and one spring, when Tristan was around 2 years old, his eczema suddenly flared up terribly. A pediatric dermatologist advised us simply to continue to moisturize with over-the-counter products and apply stronger doses of topical steroids.

Well, pretty much all the skin-care products we tried from the drugstore burned my son’s skin. He would run away in fear and then cry after the cream was applied; stinging him and making his already inflamed skin alarmingly red. I would cry too, frustrated that a cream could cause him so much pain when it was supposed to provide relief.

The topical steroids helped tremendously at first, but once we took the required breaks from them, Tristan’s skin would flare up again, each time worse than before. I asked the dermatologist about my concerns: “Why did the creams burn and why was my son’s skin worsening with topical steroid use? Could this be related to his diet?” As for the creams, we were told to try different types until we found one that didn’t sting – but all of our attempts seemed to further irritate my son’s skin.

I began to wonder if it was the alcohol in the cream that was bothering him as it was the only ingredient listed on every single product we’d tried. So we ditched the creams and moved to an alcohol-free, oil-based balm and guess what? No burning or stinging! It made sense – alcohol on eczema is like pouring alcohol on an open wound – ouch!

After that discovery we decided to look into diet and natural healing. We cut the topical steroids completely and started wet wrap therapy, an intense moisture treatment that involves wrapping the skin in damp bandages and cream. It helped to provide temporary relief, but it wasn’t enough.

Eczema behind Tristan's knees

At around 3 years old, again in the spring, Tristan’s eczema flared up worse than ever (later we determined spring pollen to be a severe trigger for him). His body was covered in eczema head-to-toe. He looked like a burn victim and scratched relentlessly. He didn’t sleep and neither did my husband or I as we took turns trying to relax Tristan during the night, while attempting to prevent him from scratching himself until he bled.

Lack of sleep, worrying about my son, stress and desperation for answers ultimately took its toll. I hit rock bottom and just didn’t know what to do. While steroids work for some patients, I knew they were not the answer for Tristan.

After further testing, Tristan was eventually diagnosed with asthma, IgE-mediated allergies to dairy and tree nuts, anaphylaxis to sheep’s dairy and multiple food intolerances, including gluten, soy, bananas and black pepper. The doctors told us that Tristan was considered atopic, the term for someone affected by allergies, asthma and eczema, and that it was unlikely he’d grow out of all these conditions.

That burning, all-consuming itch experienced by children with severe eczema can be soothed without the need for powerful oral steroids, showed a July 2014 study evaluating a process of wet clothes swaddling for atopic dermatitis.

Wet Wrap Therapy, or WWT, is a treatment for moderate to severe eczema that involves:

• Putting the patient in a warm bath for about 10 to 20 minutes.
• Then patting skin dry and applying topical medication to eczema-affected areas and moisturizer to the non-affected areas.
• At this point, clothes (or bandages) soaked in water are worn by the patient, with a layer of dry clothes pulled on over top.

“We know that putting a patient on oral steroids can give you a dramatic improvement. But then (when the drugs wear off) you have this dramatic rebound, and how many times are you going to do that?” says study author Dr. Mark Boguniewicz, pediatric allergist and immunologist at National Jewish Health in Denver. In his view, “eventually the side effects are worse than what you’re treating.”

For the study, 72 children between the ages of 6 months and 12 years underwent WWT for 2 to 16 days. After finishing the therapy, all study participants had significantly reduced eczema, and this improvement lasted for a whole month afterward.

As well, none of the participants had to use the stronger eczema drugs in the month following.

“On average these children did the wet wrap therapy for four days, and yet the benefit was lasting,” says Boguniewicz, whose study was published in published in the Journal of Allergy and Clinical Immunology. He views this treatment is a crisis intervention, to help calm the itch when eczema flares up and nothing seems to be providing relief.

Atopic dermatitis affects almost 20 percent of school-aged children and 3 percent of adults.

Multiple medical organizations from around the world have come together to create new interim guidelines for infant peanut consumption following a landmark study that showed early, rather than delayed introduction of peanuts can protect against the development of allergy.

The British LEAP (Learning Early About Peanut Allergy) study, published earlier this year in The New England Journal of Medicine, found that feeding peanut to young infants with heightened allergy risk – as defined as having egg allergy, eczema or both – reduces the odds that a peanut allergy will develop by a remarkable 70 to 80 percent.

“This consensus communication addresses the need for interim guidance to help physicians integrate the LEAP study findings to other similar high-risk children while food allergy guidelines undergo updates,” said AAAAI president Dr. Robert Lemanske Jr.

When presenting the LEAP findings at the 2015 AAAAI annual meeting in Houston, study author and professor of pediatric allergy at King’s College London Dr. Gideon Lack noted that, there appears to be a “narrow window of opportunity to prevent peanut allergy.” These interim guidelines are designed to help health-care providers identify these areas of opportunity and make the necessary interventions.

Key Points of the Interim Guidelines

Given LEAP’s findings, infants should be introduced to peanuts or peanut-containing products between ages 4 to 11 months of age.

Infants who show signs of eczema or egg allergy within the first 4 to 6 months of life should be tested for peanut allergy with a skin prick test and possibly also a medically supervised peanut challenge. Families with such a child should work with a physician to facilitate safe, early introduction of peanut if possible.

Though LEAP details many aspects of how peanut can be introduced, physicians should note that it does not discuss alternative doses of peanut, the minimal length of treatment necessary to induce tolerance, the potential risks if peanut consumption is stopped early, or what happens if the infant does not consume peanut on a regular basis.

Current guidelines do not state that introduction should be delayed, however, they also do not actively recommend early introduction for high-risk children between 4 to 6 months of age – the optimal window for inducing tolerance according to LEAP study findings.

The new recommendations, published in the Journal of Allergy and Clinical Immunology, are the result of a collaboration between a dozen medical organizations from countries including the U.S., Japan, Australia, Israel and Canada, as well as the European Academy of Allergy and Clinical Immunology and the World Allergy Organization.

More extensive formal guidelines from the National Institute of Allergy and Infection Diseases (NIAID) are expected to follow within the year.

We narrow down readers’ frequently asked questions, while our expert sources turn to lab experiments, studies, and even satellites orbiting the planet to offer up answers.

1. Can I outgrow a pollen allergy?

“We used to think so,” says allergist Dr. Richard Weber, which is not what many of us want to hear. Conventional understanding from earlier in the 20th century was that seasonal allergies peaked in a person’s 20s, 30s and 40s, then often faded in middle and old age. Weber, a professor of medicine at National Jewish Health in Denver, says something is changing, and that no longer appears to be the case.

Today, tests show allergic antibodies are sticking around in the bloodstream later in life, and some patients in their 50s and 60s are reporting new hay fever symptoms that they had never before experienced.

Allergies, asthma, and the itch and dryness of eczema have all become more prevalent in Western countries in the past 50 years. Weber says it may be that we’re exposed to different pollens, or more of it, or that pollen seasons are longer, thanks to climate change.

At her clinic, Dr. Anne Ellis, an allergist and associate professor of medicine at Queen’s University in Canada, also has some adult patients turning up who’ve never had seasonal allergies before. There’s no clear answer why these new sensitivities seem to occur out of the blue. “It can be really dramatic when somebody moves from one location to another, even within the country, or moves to the U.S. Northeast or Canada from a place where an allergen like ragweed isn’t so prevalent,” she says.

2. Why am I wheezing and coughing? Can pollen reach into my lungs?

Pollen grains themselves are too large to get into the lungs, says Weber, if who has been studying pollen and how it triggers allergies for 35 years. However, within the cocktail that pollen grains release when they land in the nose are smaller particles coated with allergy-stimulating proteins.

These coated particles are small enough to inhale deeply into the lungs.

They travel down your airways, meet up with IgE antibodies that your allergy-prone immune system produces to protect against them, and this sets off irritation and swelling in lung tissue.

Unlike your nose, Weber says, the airways have smooth muscle lining the bronchial tubes. Some of the chemicals released in response to pollen proteins cause the smooth muscle cells to contract, leading those with asthma to wheeze as the air whistles through the constricted pipes.

3. Are some pollens more aggravating than others?

Some pollens, like that of the birch tree, are considered more allergenic. Pine, on the other hand, gives off a lot of pollen, but tends to cause less hay fever grief.

The experts say, however, that it’s really not so much one pollen versus another, but what you’re specifically allergic to, what’s growing in abundance in your community, and how much of the allergen you will be exposed to.

Weber points to a study showing that in a single year, an alder tree can produce 7.2 billion pollen grains, while a birch can disperse more than 5.5 billion grains. You can certainly be allergic to an oak tree’s allergen, but an alder will be producing seven times the pollen.

In California, it might be eucalyptus and camphor that are your undoing. In the southwestern U.S., juniper and olive trees are some of spring’s biggest irritants, and if you live in Texas, “cedar fever is a real thing,” Weber says. Junipers and elms are troublemakers from the Midwest down to Florida, and New Englanders best steer clear of pine, oak, and mulberry trees.

In Canada, those on the west coast will find red alder and Garry oak their nemeses, while those farther east have birch, elm, maple, oak and poplar to blame for their pollen symptoms.

4. How far can pollen travel?

The answer will surprise you. In 1998, one of Levetin’s colleagues 1,050 miles northeast in Ontario, Canada detected cedar pollen from Oklahoma in the middle of January. It took about a day and a half to get there.

Weber points to a case where researchers found pollen on the remote south Atlantic island of Tristan da Cunha – at least 2,800 miles from where it naturally grows in South America.

More commonly, you should expect to be exposed to pollen from several blocks away, from trees lining civic boulevards to your local schoolyard.

5. Is climate change affecting people’s pollen allergies?

Yes, climate change is implicated in aggravating pollen allergies in three ways. First, by either lengthening the pollen season or moving it earlier or later, so there’s less; overlap between grass and tree pollination time. The second way is by expanding the area where a plant can grow, exposing people to new pollens. The third means is by stimulating plants to churn out more pollen than they ever did before.

A seminal study found that, thanks to climate change, the autumn ragweed pollen season is getting longer, particularly in the Midwest and the Canadian prairies. The study took 15 years of pollen counts and weather data from a band of cities stretching from Texas to Saskatchewan, and compared the annual length of ragweed’s pollen season.

The result? Since 1995, ragweed season north of the 44th parallel is from anywhere from 13 to 27 days longer. “This does mean suffering in the north,” says well-known University of Tulsa aerobiologist Estelle Levetin.

At the same time, plants are slowly migrating north, bringing their allergenic pollens with them. For instance, several spruce species are expanding north in Alaska, Canada and Sweden. Levetin says aerial photography also shows shrubs in parts of Alaska where they weren’t seen 50 years ago.

Then there are the chemical changes of climate change: the growing concentrations of carbon dioxide, ozone and nitrogen dioxide. A USDA review concludes that plants thrive in higher carbon dioxide environments, sprouting more flowers and producing more pollen. Plants exposed to carbon dioxide and ozone may also produce pollen with more allergenic proteins – a double whammy for those with hay fever.

Next: Can you really trust pollen forecasts?

]]>http://allergicliving.com/2015/04/16/10-biggest-pollen-allergy-questions/feed/0What LEAP Study’s Results Mean For Youhttp://allergicliving.com/2015/03/19/what-leap-means-to-your-family/
http://allergicliving.com/2015/03/19/what-leap-means-to-your-family/#commentsThu, 19 Mar 2015 12:50:44 +0000http://allergicliving.com/?p=33372Let’s shed some light on what the landmark study does – and does not – mean.

First, the LEAP (Learning Early About Peanut Allergy) study applies only to allergy prevention in infancy. It doesn’t change life at all for those who already have a peanut allergy; the need for allergen avoidance remains the same for them.

Allergic Living put some key questions to Dr. Scott Sicherer, chief of allergy and clinical immunology at the Icahn School of Medicine at Mount Sinai, to help readers understand the implications of LEAP.

Is the study likely to change the advice that allergists or pediatricians give to pregnant moms?

Dr. Scott Sicherer

In one sense, “no”. Since a reversal of suggestions from the American Academy of Pediatrics and other groups seven years ago, there has been no advice to delay introduction of peanuts (or other allergenic foods) for “healthy” infants. Medical organizations are now working to incorporate the study results into general feeding guidelines for healthy infants.

For infants prone to allergy, the results at least suggest that inordinate delays in introducing peanut, and perhaps other allergens, may be counter-productive. The study’s results are in line with the prior conclusions.

However, the study results strongly impact the approach for infants who are showing signs of an allergy. It is known that an infant with severe eczema or egg allergy (and other food allergies), like those in the study, are at increased risk for having or developing additional food allergies, including peanut. This risk has typically resulted in delaying the introduction of peanut.

The LEAP study results strongly suggest that early evaluation for peanut allergy and early introduction, if possible, may reduce the risk. Expert panels are also formulating approaches for infants at “high risk”.

If a parent of a young baby has a food allergy and has had allergic reactions, what should that family now do in regard to feeding – or not feeding – peanut to the child?

First, seek out your allergist’s advice. I suspect that allergists will follow the process of the LEAP study, with allergy testing and medically supervised feedings, as deemed necessary.

This will require understanding on the part of families that some infants react at that first feeding or may at some point develop symptoms. The families in the LEAP study had to make a commitment to incorporating a specified amount of infant-safe forms of peanut into the diet, and we do not know the implications of variations on that “dosing”.

We also do not yet know if children are indefinitely dependent on the feeding regimen, or if they will remain peanut-allergy “free” when not purposely and frequently eating peanut.

My child has a peanut allergy and I didn’t give him peanut until age 3. Does this mean it’s my fault that he’s allergic?

We do not fully understand the reasons we have seen an increase in food allergies. Food allergy is a result of complex interactions of genetics and environment. You have likely read about the hygiene hypothesis, vitamin D theory, unhealthy fats, and other theories to explain the increase in food allergy and other allergic diseases. It is likely that many factors have conspired to promote allergy.

I would not blame yourself(!) but if you have to place blame it might be placed on your ancestors and on circumstances of modern living.

The researchers were introducing peanut to babies at only four months old. Isn’t that pretty young for such a food?

Professional groups and expert panels are formulating guidance, which is difficult given that the study evaluated only one specific scenario in “high risk” infants, and they were ages four months up to 11 months.

Peanuts and peanut butter are choking hazards for infants, and peanut is not considered among “first foods” for infants. The study addressed this by using specific forms of peanut that were very smooth and safe for infants, given under careful guidance. I am not aware of infants being fed peanut as a first or very early food, even decades before a rise in allergy was noted.

For context, in an earlier, related study of Israeli Jewish children who had a much lower rate of peanut allergy than was observed among Jewish children in the U.K., peanut was incorporated into the diet around seven months of age. (The U.K. infants generally had no peanut over the first year of life.)

Babies who had more highly positive skin results weren’t part of this study. What about young children who appear to already be allergic to peanut?

I think that allergists will discuss this scenario individually. It is likely that more of these infants will react upon first ingestion of peanut, which has to be balanced with the uncertain but possibly beneficial impact of attempting to incorporate peanut in the diet if they tolerate a first feeding.

Neal Patel was in the middle of writing his medical board exams when suddenly, his skin began to itch. This wasn’t a normal itch. It was the feeling that he had grown up with, the one he had prayed would not happen that day. He could feel his body getting warm and though he kept his hands firmly on his test papers, his mind was overwhelmed by the need to scratch.

“It was almost this feeling of impending doom. You feel it. You feel this heat coming on and you feel that your body is about to flip,” he explained. “I spent so much energy trying to force myself not to itch that I wasn’t able to read.” Finally, he had to get up and take an hour-long break from the exam to scratch his entire body and apply lotion.

The 26-year-old New Jersey Medical student is one of nearly 18 million Americans who suffers from moderate to severe eczema. Patel has endured flare-ups of painful, dry, broken skin all over his body since birth. As an adult, his condition caused cuts that bloodied his sheets, required him to wear silk garments under his clothes, and made simple tasks like exercise or showering a burden. But for the first time, thanks to a novel drug, Patel is finding relief from the extreme itch of eczema.

The drug, dupilumab, is a weekly injection that blocks two signaling proteins which are key to the immune response that leads to the cracked, dry and inflamed skin of eczema, or atopic dermatitis. Essentially, unlike other treatments, this drug treats the root cause of the disease rather than its symptoms. Results from the study, published in the Journal of Allergy and Clinical Immunology, are so promising that the FDA has designated the drug a “breakthrough therapy” to fast-track its development for moderate to severe eczema.

“With this treatment, we managed to show that when you target specific molecules in the skin, you basically improve the skin barrier, proving that it’s primarily an immune abnormality that we need to go after,” lead author Dr. Emma Guttman-Yassky, told Allergic Living.

When Patel first met with the New York researcher, his skin was peeling and weeping. His symptoms were so severe that he agreed to take a year off to participate in her clinical trial for the experimental drug.

Prior to dupilumab, eczema like Patel’s was usually treated with corticosteroids or cyclosporine immunosuppressant pills. But both carry the risk of side effects such as kidney and blood pressure problems and once the dosage is complete, symptoms often return, as Patel says, “with a vengeance.”

After the first injection of the new drug, Patel noticed he was itching less. After the second dose, his skin began to clear up, allowing him to return to routine tasks like exercise and daily showers, without worrying about drying out or irritating his eczema – results that Guttman-Yassky says are fairly typical.

According to the dermatologist’s research, in one month, patients who received weekly 300 mg injections of dupilumab showed greater disease control than those who are on cyclosporine pills for three months.

“It was like my skin became stronger, more durable, more tough. Everything really changed,” Patel sad in an interview. “It was so dramatic it was unbelievable.”

Dr. Emma Guttman-Yassky, The Mount Sinai Health System

Guttman-Yassky, a dermatologist at the Icahn School of Medicine at Mount Sinai, says that by targeting specific molecules related to the disease, rather than the immune system at large, side effects are reduced and the effectiveness is increased. So far, no major side effects have been seen with dupilumab.

This is also the first study to ever confirm that eczema is, in fact, an autoimmune disorder. According to Guttman-Yassky, who was motivated to study this condition because both she and her daughter have eczema, this novel type of targeted therapy is not limited to eczema treatment – in fact, her results have already prompted research into multiple new therapies for asthma, psoriasis and other disorders.

“Dr. Guttman-Yassky is really changing the world,” said Dr. Mark Lebwohl, chair of Mount Sinai’s dermatology department. “She is opening the door to new therapeutic discoveries and helping to improve the quality of lives of patients.”

Neal Patel (left) after sharing his story with Dr. Sanjay Gupta

With his eczema at bay, Patel, who now self-administers the weekly injections at home, approaches his professional, dating, and social life with confidence and comfort. He hasn’t had a flare-up since starting the drug.

“I still have [eczema] but it’s way more manageable,” he says. “My life has changed in that I’ve regained normalcy now.”

Dupilumab is still being tested, but Guttman-Yassky hopes the drug could be available as soon as 2017.

The skin may hold the answer as to why some children develop peanut allergies before they’ve even eaten a single peanut, suggests new research.

Dr. Helen Brough is the lead author of a groundbreaking British study that reveals how exposure to peanut residue in household dust can increase the risk that children with eczema or other skin conditions will go on to develop peanut allergy.

Allergic Living has an exclusive interview with Dr. Brough but first, some background on the study:

Researchers vacuumed sofas in the homes of 577 U.K. babies in their first year of life.

Detectable peanut protein was found in more than 1/3 of the dust samples.

Years later, at ages 8 and 11, the children in this same study group were tested for peanut allergy, as well as mutations of the FLG skin gene (such mutated genes are strongly associated with eczema).

Of those who had become peanut-allergic, 1 in 5 had the mutated FLG gene.

In homes with 3 times as much peanut in the dust, a child with the mutated gene was 3 times more likely to develop peanut allergy.

“Previously it was thought that children developed a predisposition to becoming peanut allergic by exposure to peanut from maternal peanut consumption during pregnancy or breastfeeding,” explains Dr. Brough, an honorary senior lecturer at King’s College London. “This study suggests that there may be an alternative route by which children might develop become peanut allergic – and that is through exposure to peanut through the skin.”

In the following interview with Associate Editor Ishani Nath, pediatric allergist Dr. HelenBrough discusses her groundbreaking study and what it could mean for our understanding of how peanut allergies develop.

Allergic Living: What is it about the skin and its immune system that is leading to allergy?

Dr. HelenBrough: In children with porous skin (due to FLG mutations) allergens are thought to penetrate the skin and predispose the body towards an allergic response. There is evidence that disruption of the skin – through constant scratching, irritation or inflammation – leads to an allergic immune response in the skin. Peanut could therefore penetrate disrupted skin when the immune system is predisposed towards allergy, and lead to a peanut-allergic response.

Infants in the study who did not have the mutated FLG gene were safe from the effects of peanut proteins in household dust.

AL: How does peanut protein get into household dust?

DB: Peanut can be measured on hands and in saliva at least three hours after eating a peanut-containing meal. Thus, peanut can be transferred into the environment by hands or saliva, for example onto bedding while asleep, for some time after eating peanuts.

AL: If you don’t eat peanuts in your home, will there still be peanut protein in your household dust?

DB: In our study, peanut protein was found in the dust of the infant’s bed and play area in about 10 percent of homes where there was no or minimal household peanut consumption. This may have been due to other friends and family visiting the home who did eat peanut.

Using creams with food-based ingredients on broken skin could cause new food allergies to develop, concludes a new case report published in the Journal of Allergy and Clinical Immunology: In Practice, a publication of the American Academy of Allergy, Asthma & Immunology (AAAAI).

“Application of these “natural” products containing food allergens to eczematous skin may lead to a severe allergic reaction when the food is eaten subsequently,” Dr. Robyn O’Hehir, one of the authors of the report, told Allergic Living.

The scientific article notes that a 55-year-old woman experienced first-time anaphylaxis to goat cheese after weeks of using a moisturizer containing goat’s milk on her eczema-affected skin. She had never reacted to goat products before. The scientists then confirmed the allergy with blood testing.

This is not the first report of a skin product suspected of causing an allergy, but the authors believe this is the first time that laboratory tests have been used to confirm that a skin cream was the cause of the sensitization.

While it’s important for eczema sufferers to keep their skin well-hydrated, patients should take care to apply moisturizer to intact skin only, “with the specific prescribed medicinal ointments applied to the broken, inflamed skin,” advises O’Hehir, who is director of the department of allergy, immunology & respiratory medicine at Monash University in Australia.

O’Hehir also notes that such so-called natural creams are unlikely to cause any problems for most people with unbroken skin.

One big concern is the fact that in the United States and Canada, unlike packaged foods, cosmetic products don’t have to conform to strict guidelines for labeling of allergenic ingredients. The AAAAI warns that flavors, fragrances and trade secret ingredients do not currently have to be listed on cosmetics.

Aside from goat’s milk, O’Hehir notes that food-based ingredients in cosmetics can include nut oils, soy milk, cow’s milk and oats. Other sensitizing agents include lanolin (from sheep’s wool), fragrances, plant extracts and cinnamon extracts in toothpaste. She says these products should be used with caution, and that a patient should stop their use if symptoms arise, and follow up with a doctor.

“Our strong message to all patients, and especially those with eczema, is to choose and use bland skin care products, avoiding those that contain food,” says O’Hehir.

]]>http://allergicliving.com/2014/06/19/woman-develops-severe-food-allergy-after-using-skin-cream/feed/0Safe Makeup Tips for Eczema (Atopic Dermatitis)http://allergicliving.com/2014/06/09/safe-makeup-tips-for-eczema-atopic-dermatitis/
http://allergicliving.com/2014/06/09/safe-makeup-tips-for-eczema-atopic-dermatitis/#commentsMon, 09 Jun 2014 21:28:02 +0000http://allergicliving.com/?p=26866Q. My teenage daughter has eczema (atopic dermatitis) that now seems under control. She’s asking about wearing makeup. What do you think would be safe for her to try?

Dr. Skotnicki: I always like the analogy of atopic eczema and asthma. If you have asthma, you don`t smoke since the smoke may cause a flare-up of your asthma. You’re not “allergic” to the smoke, the issue is that it will irritate your airways.

The same is true for atopic eczema.

If you have atopic eczema and you use the wrong products, they will cause your eczema to flare because they act as irritants. With atopic eczema, it is common for people like your daughter to find their skin irritate by the ingredients of makeup and toiletries.

Fragrance is the biggest offender, and this includes natural or botanical scents. Other ingredients that give makeup shimmer or shine, such as mica, as well as sunscreen are irritants. Your daughter would be smart to avoid makeup with shine or shimmer.

Be mindful as well that any product that has water in it will need to be preserved. Some of the preservatives are irritants as well as allergens.

Mineral-based makeup are often safer choices – because they have no water, and therefore are not preserved, and they usually have no fragrance added. But I still would avoid mineral makeups with shimmer.

It is best to add one new makeup product per week, as it can take four to seven days for an irritant flare of eczema. Fragrance – and botanical-free makeups (e.g. Clinique) are good bets as are some mineral-based brands.

First published in Allergic Living magazine.
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]]>http://allergicliving.com/2014/06/09/safe-makeup-tips-for-eczema-atopic-dermatitis/feed/0What is Contact Dermatitis?http://allergicliving.com/2014/04/01/what-is-contact-dermatitis/
http://allergicliving.com/2014/04/01/what-is-contact-dermatitis/#commentsTue, 01 Apr 2014 15:02:48 +0000http://allergicliving.com/?p=25066Q. I have hand eczema that is red, scaly and itchy. My doctor thinks it’s “contact dermatitis” and is sending me for patch testing. Can you tell me about the condition and test? FYI, I’m a caterer, so I do wash my hands a lot.

Dr. Skotnicki: Contact dermatitis is a common occupational medical issue. It will occur in occupations where there is exposure to irritants such as soap and gloves and less frequently due to true allergic reactions to chemicals.

Contact dermatitis encompasses both irritant contact dermatitis and allergic contact dermatitis. The test to determine whether a chemical is causing an irritant rather than an allergic reaction is called patch testing. This is not what an allergist does when they prick your inner arm. Prick testing, as that is known, determines allergy to things you ingest or inhale, such as peanuts or ragweed.

Patch testing determines allergy to a chemical contacting your skin. For this test, patients have to visit the dermatologist three times over a week.

On day one, chemicals are applied to the back and covered with paper tape. On day three they are removed, and on day five the back is examined for signs of eczema. If there is a reaction, the patient has tested positive to that chemical and it could be the cause of their eczema.

As a caterer you most likely have irritant contact dermatitis due to frequent hand washing and glove wearing. It’s important to have patch testing to rule out a true allergy to ingredients in the soap or rubber as the cause. If the test is negative, you likely have irritant contact dermatitis. Treatment for this condition involves decreasing your irritant exposure and treating the eczema with proper medication.